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©The Author(s) 2019.
World J Clin Cases. Jan 6, 2019; 7(1): 1-9
Published online Jan 6, 2019. doi: 10.12998/wjcc.v7.i1.1
Published online Jan 6, 2019. doi: 10.12998/wjcc.v7.i1.1
Table 1 Risk factors for the development of dysplasia in inflammatory bowel disease
Risk factors | Endoscopic factors |
Disease duration | Active disease |
Disease extent | Presence of strictures in ulcerative colitis |
Disease severity | Post inflammatory polyps |
Past dysplasia | Tubular appearance of colon with loss of colonic haustration |
Primary sclerosing cholangitis | |
Family history of colorectal cancer |
Table 2 Commonly used guidelines for the screening of neoplasia in inflammatory bowel disease
Society | Commencement | Risk stratification | Interval |
ECCO, 2017 | 8 yr post symptom onset | Stricture or dysplasia, PSC, extensive colitis, severe active inflammation | Annual |
Mild to moderate active inflammation, post inflammatory polyps, or first degree relative with CRC | 2-3 yr | ||
None of the above features | 5 yr | ||
AGA, 2010 | 8 yr post diagnosis | Active inflammation, stricture, post inflammatory polyps, history of dysplasia, first degree relative with CRC, PSC | Annual |
After 2 negative colonoscopies | 1-3 yr | ||
ACG, 2010 | 8-10 yr post diagnosis | No risk stratification | 1-2 yr |
BSG, 2010 | 10 yr post symptom onset | Moderate/severe active inflammation on the prior colonoscopy, stricture, dysplasia, PSC, first degree relative with CRC aged < 50 yr | Annual |
Mild active inflammation on prior colonoscopy, post inflammatory polyps, first degree relative with CRC aged > 50 yr | 3 yr | ||
Nil prior inflammation, left sided colitis or CD colitis affecting > 50% surface area of the colon | 5 yr |
Table 3 Low, intermediate, and high risk features to risk stratify patients and guide surveillance intervals
Low risk | Intermediate risk | High risk |
Quiescent disease, even with extensive colonic involvement; left sided IBD | Extensive colonic involvement with mild inflammation; post inflammatory polyps; CRC in 1st degree relative aged > 50 | Extensive colitis with moderate/severe inflammation; primary sclerosing cholangitis; colonic strictures1; dysplasia of any grade1; CRC in 1st degree relative aged < 50 |
Table 4 SCENIC consensus nomenclature of dysplasia in inflammatory bowel disease
Term | Definition |
Visible dysplasia | Dysplasia confirmed histologically on a targeted biopsy |
Invisible dysplasia | Dysplasia on a random biopsy |
Polypoid | Lesion protruding ≥ 2.5 mm into the lumen |
Non polypoid | Lesion protruding < 2.5 mm into the lumen or not protruding |
Superficial elevated | Protrusion < 2.5 mm |
Pedunculated | Attached to mucosa via stalk |
Sessile | Not attacked via stalk; base contiguous with mucosa |
Flat | No protrusion above mucosa |
Depressed | At least a portion of lesion depressed below mucosa |
Ulcerated | Fibrinous appearing base within lesion |
Distinct border | Easily identified from surrounding mucosa |
Indistinct border | Not discrete; difficult to distinguish from surrounding mucosa |
- Citation: Manchanda S, Rizvi QUA, Singh R. Role of endoscopy in the surveillance and management of colorectal neoplasia in inflammatory bowel disease. World J Clin Cases 2019; 7(1): 1-9
- URL: https://www.wjgnet.com/2307-8960/full/v7/i1/1.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v7.i1.1